Role of the Windrush Generation in Founding the National Health Service
Black people have played a central role in the National Health Service (NHS) since its founding. The NHS was established as part of the reconstruction effort following the Second World War. Previously, healthcare was available only to those with the means to afford it, thus resulting in severe inequities and enormous suffering among poor Britons from the effects of poor nutrition and disease. After the war, Aneurin Bevan, the Labour Minister of Health, conceived of a system whereby the entire nation would contribute to free health care through a National Insurance plan, and the NHS was officially established in 1948. However, as noted above, the war had left Britain with severe labour shortages, and the government found it impossible to staff the 2688 hospitals that it had taken over with the passing of the National Health Service Act (Dent, 2018). Amidst the post-War economic boom, it was extremely difficult to recruit men to work for the NHS, which primarily offered lower paying jobs for long hours in poor conditions, and the newly independent single women could also afford to be more selective about their career choices, and most took up occupations in white collar positions such as secretaries and journalists.
Thus, it was necessary to recruit the staff for the Service from the colonies, particularly those in the Caribbean, and in 1949, the Ministries of Health and Labour, the Colonial Office, the General Nursing Council (GNC) and the Royal College of Nursing began collaborating to attract women and men from the Caribbean and other colonies to apply for work as hospital auxiliaries, nurses and trainee nurses, and domestic workers. Thousands of recruits responded during the 1950s and 1960s, many paying their own fares, and were trained to the highest levels in their profession according to British standards. Most found themselves assigned not to the General or teaching hospitals staffed by White Britons, but rather trained in institutions dedicated to the care of the chronically sick, disabled and the elderly, as well as psychiatric hospitals, where populations had increased dramatically due to the massive impact of post-war trauma.
Despite the country’s enormous need for these clinicians, many of whom already had the requisite qualifications, racial discrimination was a strong factor in the training they received, and most Caribbeans and Black British nurses were placed on the two-year ‘Pupil’ or State-Enrolled Nursing (SEN) course, which focused on lower-paid clinical nursing and offered fewer opportunities for promotion, rather than the more advanced ‘Staff’ or State Registered Nurse (SRN) qualification programme, which included training in ward management and other leadership duties (Ramdin, 1987). The trainees lived in Nurses’ Homes attached to the hospitals, and most settled in large cities with already existing African and Caribbean populations. By 1966, there were an estimated 3,000-5,000 Jamaican nurses working in British hospitals (Snow & Jones, 2011). Although many had planned to return home after receiving their training, their options were limited by the SEN course, which was not recognised outside Britain, and efforts to obtain the full training were usually rebuffed.